Expression of cytokines at baseline correlate/predict in the disc the outcome of surgery after disc degeneration: A 12-month follow-up study.

Background: Low back pain (LBP) is a highly prevalent condition that comprise a large portion of outpatient practice, challenging the diagnosis and treatment. However, the diagnostic tools are limited to clinical history, physical examination and imaging. Degenerative disc disease (DDD) is a significant cause of LBP, and emerging literature confirms the elevated levels of biomarkers in the discs.

Involuntary sedation of patients in the emergency department for mental health: A retrospective cohort study.

Background: Involuntary sedation of agitated mental health patients in the Emergency Department (ED) is standard practice to obtain accurate medical assessments and maintain safety. However, the rate of this practice and what factors are associated with the use of involuntary sedation is unknown. The purpose of this study was to obtain baseline data on involuntary sedation in our EDs.

Para-aortic lymph node involvement should not be a contraindication to resection of pancreatic ductal adenocarcinoma.

Background: Para-aortic lymph nodes (PALN) are found in the aortocaval groove and they are staged as metastatic disease if involved by pancreatic ductal adenocarcinoma (PDAC). The data in the literature is conflicting with some studies having associated PALN involvement with poor prognosis, while others not sharing the same results. PALN resection is not included in the standard lymphadenectomy during pancreatic resections as per the International Study Group for Pancreatic Surgery and there is no consensus on the management of these cases.

Decline and Pronounced Regional Disparities in Medical Cocaine Usage in the United States.

Cocaine is a stimulant and Schedule II drug used as a local anesthetic and vasoconstrictor. This descriptive study characterized medical cocaine use in the United States. Retail drug distribution data from 2002 to 2017 were extracted for each state from the Drug Enforcement Administration, which reports on medical, research, and analytical chemistry use.

Evaluation of Splenic Artery Embolization Technique for Blunt Trauma.

Introduction: Evaluate outcomes and radiation exposure across different splenic artery embolization (SAE) techniques for splenic injuries secondary to blunt trauma.

Methods: This retrospective cohort study included patients 18 years of age or older who underwent SAE for splenic injury after blunt trauma from January 2011 to June 2019.

Results: Sixty patients underwent angiography for splenic injury after blunt traumatic injury.

Low back pain scores correlate with the cytokine mRNA level in lumbar disc biopsies: a study of inflammatory markers in patients undergoing lumbar spinal fusion.

Purpose: The molecular mechanism behind pain in degenerative disc disease (DDD) and chronic low back pain (LBP) patients is largely unknown. This present study examines the association of LBP and disability to mediators of the inflammatory cascade, as indexed by mRNA gene expression of pro-inflammatory cytokine markers in the intervertebral disc (IVD).

Methods: Biopsies of the annulus fibrosus (AF) and the nucleus pulposes (NP) from patients with DDD undergoing 1-2 level fusion surgery at L4/L5 or L5/S1 were obtained from total of 34 patients [9 M, 25 F] with average age of 53 [32-63].

Treatment variables associated with outcome in emergency department patients with suspected sepsis.

Background: Early treatment is advocated in the management of patients with suspected sepsis in the emergency department (ED). We sought to understand the association between the ED treatments and outcome in patients admitted with suspected sepsis. The treatments studied were: (i) the time to antibiotics, where time zero is the time the patient was booked in which is also the triage time; (ii) the volume of intravenous fluid (IVF); (iii) mean arterial pressure (MAP) after 2000 ml of IVF and (iv) the final MAP in the ED.

Correction to: Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know.

Unfortunately, the original publication of this article contained a mistake in Fig. 7a. The correct figure is presented here.

Radiographic review of anatomy and pathology of the masticator space: what the emergency radiologist needs to know.

The differential diagnosis of a masticator space (MS) lesion is broad, owing in part to the multiple structures contained within such a small region. It is also because the MS is adjacent to many of the other deep spaces within the head and neck, which can act as gateways for disease spread. Therefore, emergency radiologists must be familiar with anatomy of the MS, as well as adjacent spaces in order to provide an accurate diagnosis to the referring clinician.

The nuclear translocation of insulin-like growth factor receptor and its significance in cancer cell survival.

The nuclear translocation of insulin-like growth factor receptor type 1 (IGF-1R) has been documented in a variety of previous studies. The exact mechanism of this translocation, however, is still poorly understood. Furthermore, the functional role of IGF-1R in the nucleus shows promise of transcriptional control.

The REDS score: a new scoring system to risk-stratify emergency department suspected sepsis: a derivation and validation study.

Objective: To derive and validate a new clinical prediction rule to risk-stratify emergency department (ED) patients admitted with suspected sepsis.

Design: Retrospective prognostic study of prospectively collected data.

Setting: ED.

Anaesthetic Management in a Child with Goldenhar Syndrome.

Goldenhar syndrome is a congenital disorder involving deformities of the face. It usually affects one side of the face only and poses significant challenges in the airway management. We herein, report an 8-year boy, known case of Goldenhar syndrome, who presented to our radiology suite for a magnetic resonance imaging (MRI) brain, followed by a computed tomography (CT) scan brain.

Systems thinking in public health: a bibliographic contribution to a meta-narrative review.

Background: Research across the formal, natural and social sciences has greatly expanded our knowledge about complex systems in recent decades, informing a broadly inclusive, cross-disciplinary conceptual framework referred to as Systems Thinking (ST). Its use in public health is rapidly increasing, although there remains a poor understanding of how these ideas have been imported, adapted and elaborated by public health research networks worldwide.

Method: This review employed a mixed methods approach to narrate the development of ST in public health.

Workforce Competencies in Syndromic Surveillance Practice at Local Health Departments.

Context: As the science and practice of syndromic surveillance (SyS) evolve, it has increasing utility for public health surveillance at the local level. Local health departments (LHDs) require specific organizational and workforce capabilities to use SyS data. In 2013, more than half of the LHDs reported using SyS, although little has been reported about LHD workforce capabilities in SyS.

Assessment of Local Health Department Utility of Syndromic Surveillance: Results of the 2015 Biosurveillance Needs Assessment Survey.

This study describes the management and use of electronic syndromic surveillance (SyS) practice among a sample of local health departments and identifies gaps and barriers to improve individual and organizational capabilities in biosurveillance, as measured by SyS practice.

Do outcomes justify emergence of new cardiac centres.

Objective: To assess if quality cardiac surgical results can be delivered in a third world country like Pakistan.

Methods: Our report focused on the initial 2-years experience (June 2005-June 2007) at a new institution Tabba Heart Institute, Karachi. Individual mortality rates of adult cardiovascular surgeries done at our institution were compared with the Society for Thoracic Surgery (STS), European Association of Cardiothoracic Surgery (EACTS) databases and one of the more commonly applied models for predicting post-operative mortality, EuroSCORE.

A MASSive laboratory tour. An interactive mass spectrometry outreach activity for children.

It is imperative to fascinate young children at an early stage in their education for the analytical sciences. The exposure of the public to mass spectrometry presently increases rapidly through the common media. Outreach activities can take advantage of this exposure and employ mass spectrometry as an exquisite example of an analytical science in which children can be fascinated.

Efficacy of valve replacement surgery in patients with severe pulmonary hypertension.

Objectives: To evaluate the safety of valve replacement surgery in rheumatic heart disease patients with severe pulmonary hypertension (SPH); defined as pulmonary artery systolic pressure (PASP > or = 60 mmHg) on patients operated for valve replacement at Tabba Heart Institute, Karachi.

Method: From July 2005 to September 2007, total of 112 patients underwent valve replacement (AVR, MVR, AVR+MVR) at our institution. We retrospectively examined the patients with SPH.

A retrospective study of ovarian tumours and tumour-like lesions.

Background: Ovaries are common site of non-neoplastic and neoplastic lesions. They can present from the neonatal period to post menopause. Most are functional in nature and resolve with minimal treatment.

Mystery of DNA repair: the role of the MRN complex and ATM kinase in DNA damage repair.

Genomes are subject to a number of exogenous or endogenous DNA-damaging agents that cause DNA double-strand breaks (DSBs). These critical DNA lesions can result in cell death or a wide variety of genetic alterations, including deletions, translocations, loss of heterozygosity, chromosome loss, or chromosome fusions, which enhance genome instability and can trigger carcinogenesis. The cells have developed an efficient mechanism to cope with DNA damages by evolving the DNA repair machinery.

Multilocus loss of heterozygosity allelotypes identify a genetic pathway associated with progression from low to high stage disease in neuroblastoma.

Neuroblastoma is a heterogeneous tumour with a variety of clinical phenotypes, ranging from a localised tumour with excellent outcome (stage 1) to a metastatic, usually fatal malignancy (stage 4). In order to investigate the genetic relationship between these tumour subtypes, a loss of heterozygosity (LOH) analysis was carried out. Composite LOH allelotypes incorporating data from 96 loci on 5 chromosomes (1p, 3p, 4p, 11q, 14q), were constructed for 62 neuroblastomas.

The Wnt antagonist sFRP1 in colorectal tumorigenesis.

Regions of the short arm of chromosome 8 are deleted frequently in a range of solid tumors, indicating that tumor suppressor genes reside at these loci. In this study, we have examined the properties of the Wnt signaling antagonist secreted frizzled-related protein (sFRP) 1 as a candidate for this role at c8p11.2.